Provider Demographics
NPI:1316432164
Name:MAHAT, SONICA (NP-C)
Entity type:Individual
Prefix:
First Name:SONICA
Middle Name:
Last Name:MAHAT
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16830 DUMFRIES RD
Mailing Address - Street 2:STE 160
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22025
Mailing Address - Country:US
Mailing Address - Phone:703-523-1750
Mailing Address - Fax:
Practice Address - Street 1:16830 DUMFRIES RD
Practice Address - Street 2:STE 160
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22025
Practice Address - Country:US
Practice Address - Phone:703-523-1750
Practice Address - Fax:844-518-0708
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024176240363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner